Individual
GEORGE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
414 MAIN ST, BATAVIA, IL 60510-2429
(630) 803-8723
Mailing address
414 MAIN ST, BATAVIA, IL 60510-2429
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.006023
IL
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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